Comparison of Frequency of Macrosomia among Gravid Females with Gestational Diabetes Treated with Metformin vs. Insulin
DOI:
https://doi.org/10.37018/OIUY9654Keywords:
Gestational diabetes mellitus, macrosomiamacrosomia, metformin, insulin, gravid femalesAbstract
Background: Foetal macrosomia is a predominant complication of gestational diabetes mellitus (GDM), affecting approx-imately 14 to 20% of wide range of these pregnancies and significantly increasing perinatal morbidity. Insulin was tradi-tionally used but oral metformin has emerged as a promising alternative that prevents weight promoting side effects with good glycaemic control. Therefore, this study compared the frequency of macrosomia among females with GDM treated with metformin versus insulin to guide evidence-based clinical management.
Methods: This randomized controlled trial was conducted in the outpatient department of Gynaecology and Obstetrics, Government Teaching Hospital Shahdara. A total of 180 gravid females were initially enrolled; 20 were excluded for not meeting criteria, leaving a final analytical sample of 160. The participants were randomized via a lottery method with allo-cation concealment. Group I received 500 mg of oral metformin daily, while Group II was treated with subcutaneous insu-lin (0.5 units/kg/day in divided doses). Blood sugar levels were monitored weekly, and neonatal birth weight was recorded within 30 minutes post-delivery. SPSS version 25 was used to analyse data. Results were compared between the two groups.
Results: Amongst initially enrolled 180 participants, 160 were analysed (80 in Group I and 80 in Group II). The mean age was 29.04 ± 5.55 years, mean BMI was 27.41 ± 2.70 kg/m², and mean gestational age at delivery was 37.79 ± 1.54 weeks. Vaginal delivery occurred in 95 (59.4%) participants, while 65 (40.6%) underwent caesarean sections. The frequency of macrosomia was significantly lower in Group I, observed in 11 (13.8%) neonates, compared to 21 (26.3%) neonates in Group II. This represented a statistically significant reduction in the risk of macrosomia for Group I (relative risk = 0.52, 95% CI: 0.27 to 0.99, p = 0.048).
Conclusion: Metformin therapy in women with gestational diabetes mellitus resulted in a significantly lower incidence of macrosomia compared to insulin. These findings suggest that metformin is more effective than insulin specifically for re-ducing the risk of foetal macrosomia in the management of gestational diabetes.
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Copyright (c) 2026 Sofia Iqbal Sofia, Mahham Janjua, Alia Nasir-Ud-Din, Maida Naeem, Shamila Ijaz Munir
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